Provider Demographics
NPI:1609043546
Name:ELIKE INC
Entity Type:Organization
Organization Name:ELIKE INC
Other - Org Name:ELSAS PILLBOX
Other - Org Type:Doing Business As
Authorized Official - Title/Position:RPH/PIC/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ELSA
Authorized Official - Middle Name:
Authorized Official - Last Name:ORNELAS
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:361-664-7455
Mailing Address - Street 1:701 N TEXAS BLVD
Mailing Address - Street 2:
Mailing Address - City:ALICE
Mailing Address - State:TX
Mailing Address - Zip Code:78332-3883
Mailing Address - Country:US
Mailing Address - Phone:361-664-7455
Mailing Address - Fax:361-664-7461
Practice Address - Street 1:701 N TEXAS BLVD
Practice Address - Street 2:
Practice Address - City:ALICE
Practice Address - State:TX
Practice Address - Zip Code:78332-3883
Practice Address - Country:US
Practice Address - Phone:361-664-7455
Practice Address - Fax:361-664-7461
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-09
Last Update Date:2011-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX260173336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
4548319OtherNCPDP PROVIDER IDENTIFICATION NUMBER
TX145917Medicaid